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Diabetes has been identified as one of South Africa’s biggest non-communicable disease threats. According to the International Diabetes Federation, the disease caused 67 318 deaths and affected more than 3m people in the country, at a cost of about $900 (R13 500) per person in 2015. With only 2.286m cases having been diagnosed, thousands of people are unaware that they are ill.
The number of people diagnosed with diabetes is predicted to increase to well beyond 5m by 2040, due to complex reasons, including genetic factors, and changes in food consumption patterns combined with increasingly sedentary lifestyles that have come with urbanisation.
Richard Johnson and Graham Rowe, the co-founders of Guidepost, saw this trend as an opportunity to add value to medical health services.
“When we started the company four years ago, we initially wanted to offer medical treatment based on genetic sequencing. We however soon realised that much of the basics of healthcare are deeply flawed in their real-world implementation,” says Johnson.
He explained that the outcomes for diabetes in SA were pretty abysmal, in spite of great treatment protocols and excellent drugs: “Diabetes results in a lot of avoidable suffering, including complications like amputation, blindness and strokes. The problem is that only about half the people with diagnosed cases receive care and only about half of those produce positive outcomes. We therefore started a company that uses technology to enhance these outcomes.”
The challenges
Access to care is one of the big challenges with diabetes. “Hospitals and clinics are often too overburdened or inaccessible to provide patients with the necessary support and assistance,” explains Johnson. “To improve your health when you have diabetes requires serious lifestyle changes, relating to your diet, dosage and timing of medication, exercise and much more. You won’t be able to make these lifestyle changes in a one-off visit to your GP.”
He says Guidepost, which was a finalist in this year’s FNB Business Innovation Awards, is not trying to replace general practitioners (GPs), but rather trying to become an aid with which GPs could produce better disease outcomes.
The development of new technologies and the move to on-demand marketplace services, such as Airbnb and Uber, have created an environment where people can receive care whenever and wherever they want it. Guidepost is going with this flow by gathering information from clients, analysing the profiles of clients and then linking them up with suitable nurses for tele-coaching, “since outcomes have been found to be greater when you receive coaching in your own language from someone with whom you can relate”.
The service entails unlimited diabetes coaching sessions as well as coach reports and personal guidance. It also helps to reduce travel costs and time wastage for patients.
“Guidepost in effect is like having a personal trainer; you don’t get better in one session, but have someone to support you, show you new techniques, explain things and walk the path with you over a number of coaching sessions,” Johnson explains.
Access to data is an obstacle to positive outcomes on the nursing side. Johnson explains that nurses have a lot of knowledge and skill, but are often unable to make informed decisions because of the way in which data was organised. “It is much more difficult to make informed decisions when you keep data with a pen and paper in an old file, than if you use new technology to process the data into usable information, say for example of a patient’s blood glucose levels.”
“The development of big data and artificial intelligence is helping the industry to produce data-driven insights that move healthcare away form pure intuition into the realm of analytics and data-driven decision-making, says Johnson. “Our business is absolutely obsessed with data and analytics. All of the coaching we provide and the algorithms we have created use biometric data to drive decision-making, augmenting the intuition of the experienced diabetes coach. The approach has resulted in a 40% reduction in hospitalisations and complications.”
The future
Since it was founded four years ago, the company has developed a network of partner coaches throughout the country with over 30 full-time employees. It has performed more than 50 000 consultations helping over 5 000 people with diabetes improve their health. Clients are referred via doctors or they sign up directly via the Guidepost website. The company also has pharmaceutical clients, who include this service with their treatment, as they recognise the importance of having patients taking their drugs correctly.
Guidepost has taken a very systematic approach from the start, to ease future expansions. Johnson says the company’s main goal is to facilitate long healthy lives. “About 80% of people with diabetes also suffer from other co-morbidities, such as high blood pressure or high cholesterol. The company is therefore developing systems to also address these problems. It has already branched out to other management services for people with chronic kidney disease, transplants and some cancers,” he explains.
To enter this year’s FNB Business Innovation Awards, visit http://www.fnbbusinessinnovationawards.co.za/
This article originally appeared in the 27 October edition of finweek. Buy and download the magazine here.
